Ukulungiswa kwangaphandle kwenkqubo ye-OdonTOID igcina umsebenzi obo boRoubren of C1-2 kwaye iye yaxelwa kuncwadi ukuba libe nenqanaba le-fusion angama-88% ukuya kwi-100%.
Ngo-2014, uMarkus R Et al Al Alporial kwi-Scoorique Scoreive Scoriquation ye-Odontoid ye-Odontoid Fracture kwijenali yethambo kunye ne-Jaint utyargery (AM). Eli nqaku lichaza ngokweenkcukacha amanqaku aphambili endlela yokuhlisela, ukulandela iposti-up, iimpawu kunye nezilumkiso kumanyathelo amathandathu.
Inqaku ligxininisa ukuba kuphela uhlobo lwee-II ze-II ze-II ze-II zingenakuthelekisa ukulungiswa kwangaphandle kwaye ulungiso olunye lwe-screw luyathandwa.
Inyathelo loku-1: Indawo ye-intraopeetive yesigulana
I-1. I-Anterosterior yangaphandle kunye neRadiographs ye-Lateral kufuneka ithathwe kwisalathiso somqhubi.
2. Isigulana kufuneka sigcinwe kwindawo evulekileyo ngexesha lotyando.
3. Ukuqhekeka kufuneka kube kuphindelwa kwakhona ngaphambi kokuqala kotyando.
I-4. I-spine yomlomo yesibeleko mayibe yeyokufumana i-hyperexteded kangangoko inakho ukufumana ukuvezwa ngokugqibeleleyo kwesiseko senkqubo ye-ODONOID.
5. Ukuba i-hyperexterance yomqolo wesibeleko ayinakwenzeka - umzekelo, kwi-hyperextexterance ye-Odontod yenkqubo ye-ODOKID ye-ODHALAD ye-ODOKID ye-ODOKIT kwi-trunk yecala lakhe.
I-6. Ukuzibulala intloko yesigulana njengezinzileyo njengesixhobo esinokwenzeka. Ababhali basebenzisa isakhelo sentloko ye-cayfield (eboniswe kwiMifanekiso 1 neye-2).
Inyathelo 2: Inkqubo yoNyango
Inkqubo yoqhaqho ngokusemgangathweni isetyenziselwa ukubhenca umaleko ongaphandle ngaphandle kokwenzakalisa naziphi na izakhiwo ezibalulekileyo ze-asatomical.
Inyathelo 3: Inqaku lokungena
Inqaku elifanelekileyo lokungena kwindawo yangaphantsi le-ANTARPR ye-ANTRIN yesiseko somzimba we-C2 vertebral. Ke ngoko, umda ongaphandle we-C2-C3 disc kufuneka ivezwe. (njengoko kubonisiwe kwi-3 ne-4 ngezantsi) umzobo 3
Utolo olumnyama kumzobo 4 lubonisa ukuba umqolo we-ANTE wangaphandle uqwalaselwe ngononophelo ngexesha lokufunda kwefilimu ye-Axial CT kwaye kufuneka isetyenziswe njengophawu lwe-anatomical lokumisela inqaku lokufakwa kwenaliti ngexesha lotyando.
2. Qinisekisa inqaku lokungena phantsi kwe-anterostool kunye nembono ye-fluoroscopic ye-fluoroscopic yomqolo wesibeleko. 3.
3. Isilayidi senaliti phakathi komda ongaphezulu we-C3 yesiphelo se-C3 kunye nendawo yokungena ye-C2 ukufumana indawo yokungena egqibeleleyo.
Inyathelo 4: Ukubekwa kwesikhafu
1. Inaliti eyi-1.8 mm ye-GEM ifakwe kuqala njengesikhokelo, kunye nenaliti yenaliti kancinane emva kwencam ye-notochord. Emva koko, i-3.5 mm okanye i-4 mm diameter holw screw ifakiwe. Inaliti kufuneka ihlale ihamba kancinci i-cetrhalad phantsi kwe-anterosteter kunye ne-Lateoroscopic ye-Fluoroscopic.
2. Beka i-golfle idle kwicala lePIN yesikhokelo phantsi kwe-fluoroscopic isfenelcopic kwaye ihamba kancinci ide ingene ekufeni. I-Drill Drill akufuneki ingene kwi-cortex yecala le-bithalad ye-notochord ukuze iPIN yeSikhokelo ayiphumi kunye ne-sholm yomngxunya.
3. Linganisa ubude be-screw efunekayo kwaye uqinisekise ngomgangatho we-CT ofanelekileyo ukuthintela iimpazamo. Qaphela ukuba isikroba esihonjisiweyo kufuneka singene kwithambo le-cortical kwincam yenkqubo ye-Odontoid (ukulungiselela inyathelo elilandelayo lokuphela koxinzelelo).
Uninzi lwamatyala ababhali, isikrelemnqa esinye sasisetyenziselwa ukulungiswa, njengoko kubonisiwe kumzobo 5, obekiweyo kwi-Odontoid inkqubo ejongene nethambo le-Odontod. Kutheni i-screw enye icetyisiwe? Ababhali baqukumbela ukuba kuya kuba nzima ukufumana indawo efanelekileyo yokungena kwisiseko senkqubo ye-odontoid ukuba izikrelem ezimbini ezahlukileyo zaziza kubekwa kwi-5 mm ukusuka kwi-MM ye-C2.
Umzobo o-5 ubonakalisa i-screw screw ephakathi kwenkqubo ye-Odontoid ejongene ne-cepholad, kunye nencam yesikhali nje ingena kwi-cortex emva nje kwencam ye-Odontoid.
Kodwa ngaphandle kwento yokhuseleko, yenza isikroba ezimbini ukonyusa uzinzo lwendawo?
Uphononongo lwebhayoloji olupapashwe ngo-2012 kwiijenali zeWenali zeWebhusayithi kunye noPhando olunxulumene neqela le-gang feng al. I-Royal Ikholeji yovavanyo lwe-United Kingdom ibonise ukuba isikhafu esinye kunye nezikrelem ezibini zibonelela ngenqanaba elifanayo lokuzinza kwe-Odontoid. Ke ngoko, isikhafu esinye sanele.
4. Xa isikhundla sokuqhekeka kunye nezikhonkwane zezikhokelo ziqinisekisiwe, ii-screws ezifanelekileyo zibekwe. Isikhundla se-screws kunye nezikhonkwane kufuneka ziqwalaselwe phantsi kweFluoroscopy.
I-5. Unonophelo kufuneka luthathelwe ukuqinisekisa ukuba isixhobo esikroba asibandakanyi izicubu ezithambileyo ezithambileyo xa zisebenza nawuphi na oku kungasentla. 6. Qinisa izikrelemnqa ukwenza uxinzelelo kwindawo yokuqhekeka.
Inyathelo 5: Ukuvalwa kwenxeba
I-1. Shubula indawo yotyando emva kokugqiba indawo yokubekwa kwesikhafu.
2. Ukucokiseka i-haepasis kubalulekile ukunciphisa iingxaki zeposi ezifana noxinzelelo lwe-hematoma.
3. I-Lasetsical ye-Latissical ye-Latississi yeLatissississis kufuneka ivalwe ngolungelelwaniso oluchanekileyo okanye i-aesthetics yesikethi sendawo esiya kulalanisa.
4. Ukuvalwa ngokupheleleyo kwamacala anzondoni akuyomfuneko.
I-5. I-Wood Doinage ayisiyo inketho efunekayo (ababhali bahlala bengafumani midlalo yeposi).
I-6. Ukuhlaziywa kwe-intradider kuyacetyiswa ukunciphisa impembelelo kwimbonakalo yomguli.
Inyathelo 6: Landela
I-1. Izigulana kufuneka ziqhubeke nokunxiba i-rigid yentamo yeeveki ezi-6 ngokuzenzekelayo, ngaphandle kokuba ukhathalelo lokukhulisa lufuna, kwaye kufuneka luvavanywe nge-tictoperaperated.
2. I-anterosterior engaphezulu ye-Anterosiver kunye ne-Atest Lateral Spine yomqolo wesibeleko kufuneka iphononongwe nge-2, 6, neeveki ezi-6 nange-12 ne-12 emva kotyando. Iskena se-CT yenziwa kwiiveki ezili-12 emva kotyando.
Iposi
